{"id":14298,"date":"2023-06-22T17:32:59","date_gmt":"2023-06-22T15:32:59","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&#038;p=14298"},"modified":"2023-06-22T17:33:00","modified_gmt":"2023-06-22T15:33:00","slug":"lessons-learned-after-post-ercp-mortality","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/lessons-learned-after-post-ercp-mortality\/","title":{"rendered":"Lessons Learned After Post-ERCP Mortality"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">ERCP is a vital endoscopic procedure for the management of pancreatobiliary disease but is associated with serious adverse events, including mortality. Although a central tenet of quality improvement is learning from negative outcomes, there is almost no literature on preventing post-ERCP mortality.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In this study, the authors utilized the Australian and New Zealand Audit of Surgical Mortality to qualitatively analyze 58 ERCP-related deaths (occurring during the same admission as ERCP) over an 8-year period to identify themes. The authors concluded that the most common modifiable factors leading to death included (but were not limited to) the following:&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Preprocedural incidents (n=37)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Delay to ERCP (n=13): for example, the inability to perform an urgent ERCP on a patient with ascending cholangitis&nbsp;<\/li>\n\n\n\n<li>Inadequate resuscitative management (n=9): inadequate intravenous fluids and\/or antibiotics&nbsp;<\/li>\n\n\n\n<li>Decision to perform ERCP (n=7): cases in which an alternative surgical procedure (eg, choledochojejunostomy) or no procedure at all may have been more appropriate&nbsp;<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Intraprocedural incidents (n=8)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Technical (n=5): examples include perforations and severe bleeding after sphincterotomy, believed to be related to operator skill rather than the procedure itself&nbsp;<\/li>\n\n\n\n<li>Support (n=3): for example, cases of inadequate anesthesia support during ERCP&nbsp;<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Postprocedural incidents (n=32)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Inappropriate treatment (n=15): among a variety of issues, examples include inappropriate triage of patients (eg, floor versus intensive care unit) and inappropriate resuscitation (both under- and over-resuscitation)&nbsp;<\/li>\n\n\n\n<li>Delay in definitive surgical treatment (n=7): generally involved delays in surgical management for ERCP perforations&nbsp;<\/li>\n\n\n\n<li>Delay in recognizing complication (n=4): an example includes the failure to recognize a duodenal perforation<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Communication-related incidents (n=8)<\/strong>&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Multiple examples of poor communication between clinicians or escalation of care (eg, from trainee to attending physician)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>ERCP is a vital endoscopic procedure for the management of pancreatobiliary disease but is associated with serious adverse events, including mortality. Although a central tenet of quality improvement is learning from negative outcomes, there is almost no literature on preventing post-ERCP mortality.&nbsp; In this study, the authors utilized the Australian and New Zealand Audit of &#8230; <a title=\"Lessons Learned After Post-ERCP Mortality\" class=\"read-more\" href=\"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/lessons-learned-after-post-ercp-mortality\/\" aria-label=\"Read more about Lessons Learned After Post-ERCP Mortality\">Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,67],"tags":[381,3763,2128,3762],"class_list":["post-14298","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-bauchspeicheldruese-pankreas","tag-ercp","tag-mortality","tag-pancreatobiliary","tag-post-ercp-morbidity"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/14298","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=14298"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=14298"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=14298"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}